Healthcare Provider Details

I. General information

NPI: 1922212653
Provider Name (Legal Business Name): ANUPAMA SHARMA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17259 JASMINE ST SUITE B
VICTORVILLE CA
92395-7787
US

IV. Provider business mailing address

PO BOX 1384
VICTORVILLE CA
92393-1384
US

V. Phone/Fax

Practice location:
  • Phone: 760-241-4959
  • Fax: 760-241-5950
Mailing address:
  • Phone: 760-241-4929
  • Fax: 760-241-5950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANUPAMA SHARMA
Title or Position: OWNER
Credential: M.D.
Phone: 760-241-4929